Detection of Glaucoma Using Scanning Laser Polarimetry with Enhanced Corneal Compensation

Medeiros, Felipe A.; Bowd, Christopher; Zangwill, Linda M.; Patel, C.S.; Weinreb, Robert N.

doi:10.1167/iovs.06-1139

Cited by 91 publications

(87 citation statements)

References 19 publications

(21 reference statements)

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“…We have recently demonstrated how a control cohort with no suspicious findings of glaucoma can affect the diagnostic ability of SDOCT parameters in glaucoma compared with a control cohort which is likely to be misinterpreted as glaucoma. 16 Due to the same reason, AUCs of RNFL parameters reported in our study are also lower compared with the studies that have reported the same with SDOCT 7,10,29 and GDx ECC 5,12,13,30 separately.…”

Section: Discussioncontrasting

confidence: 44%

“…The general principles of SLP and the algorithm used for ECC have been described in detail previously. 3,5,12 The parameters generated on the printout and used in this study were temporal average (temporal 50 degree), superior average (superior 120 degree), nasal average (nasal 70 degree), inferior average (inferior 120 degree), TSNIT (temporal superior nasal inferior and temporal) average (over 360 degree), TSNIT SD, and nerve fiber indicator (NFI). TSNIT SD represents the SD of the values contained in the calculation circle.…”

Section: Methodsmentioning

confidence: 99%

“…The amount of birefringence bias is then mathematically removed point by point from the total 1 VST Glaucoma Center, L V Prasad Eye Institute, Hyderabad, India 2 Center for Clinical Epidemiology and Biostatistics, L V Prasad Eye Institute, Hyderabad, India birefringence pattern of the image to improve the signal and obtain a retardation pattern of the RNFL with the least noise. [4][5][6] Though numerous studies have reported good diagnostic ability of both SDOCT [7][8][9][10][11] and GDx ECC 12,13 in glaucoma, there is limited literature on the head-to-head comparison of these imaging techniques in the same population. 14,15 Also, most of these studies have employed a case-control design including glaucoma patients (cases), defined based on the presence of repeatable characteristic glaucomatous visual field (VF) defects; and normal subjects (controls), usually recruited from the general population and having normal intraocular pressures (IOPs), healthy appearance of the optic nerve and normal VFs.…”

Section: Introductionmentioning

confidence: 99%

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Retinal nerve fiber layer evaluation of spectral domain optical coherence tomograph and scanning laser polarimeter to diagnose glaucoma

Rao

Yadav

Addepalli

et al. 2014

Eye

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Purpose To compare the abilities of retinal nerve fiber layer (RNFL) parameters of spectral domain optical coherence tomograph (SDOCT) and scanning laser polarimeter (GDx enhanced corneal compensation; ECC) in detecting glaucoma. Methods In a cross-sectional study, 215 eyes of 165 subjects (106 eyes of 79 glaucoma patients and 109 eyes of 86 controls) referred by general ophthalmologists for glaucoma evaluation underwent RNFL imaging with SDOCT and GDx ECC. Ability of RNFL parameters of SDOCT to discriminate glaucoma eyes from control eyes was compared with that of GDx ECC using area under operating characteristic curves (AUCs), sensitivities at fixed specificities, and likelihood ratios (LRs). Results AUC of the average RNFL thickness of SDOCT to differentiate glaucoma from control eyes (0.868) was comparable (P ¼ 0.32) to that of GDx ECC (0.855). Sensitivity at 95% specificity was 63.2% for average RNFL thickness of SDOCT and 48.1% for the average RNFL measurement of GDx ECC. LRs of outside normal limits category of SDOCT parameters ranged between 5.6 and 7.7 while the same of GDx ECC parameters ranged between 3.1 and 3.7. LRs of within normal limits category of SDOCT parameters ranged between 0.18 and 0.24 while the same of GDx ECC parameters ranged between 0.20 and 0.32. Conclusion Though AUCs and sensitivities at fixed specificities were comparable between the RNFL parameters of SDOCT and GDx ECC in diagnosing glaucoma, LRs indicated that the RNFL parameters of SDOCT were better in 'ruling in' glaucoma.

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Section: Discussioncontrasting

confidence: 44%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Retinal nerve fiber layer evaluation of spectral domain optical coherence tomograph and scanning laser polarimeter to diagnose glaucoma

Rao

Yadav

Addepalli

et al. 2014

Eye

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“…53 The introduction of a variable corneal polarization compensator (GDxVCC) attempted to alleviate this problem and resulted in improved diagnostic accuracy. 54 The GDxVCC scans, however, were found to be limited by atypical retardation patterns (ARPs). ARPs result from poor noise-to-signal ratio as a consequence of light scattering in the eye.…”

Section: Cslomentioning

confidence: 99%

Assessment of rates of structural change in glaucoma using imaging technologies

Mansouri

Leite

Medeiros

et al. 2011

Eye

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Purpose To review the ability of current imaging technologies to provide estimates of rates of structural change in glaucoma patients.Patients and methods Review of literature. Results Imaging technologies, such as confocal scanning laser ophthalmoscopy (CSLO), scanning laser polarimetry (SLP), and optical coherence tomography (OCT), provide quantifiable and reproducible measurements of the optic disc and parapapillary retinal nerve fibre layer (RNFL). Rates of change as quantified by the rim area (RA) (for CSLO) and RNFL thickness (for SLP and OCT) are related to glaucoma progression as detected by conventional methods (eg, visual fields and optic disc photography). Evidence shows that rates of RNFL and RA loss are significantly faster in progressing compared with nonprogressing glaucoma patients. Conclusion Measurements of rates of optic disc and RNFL change are becoming increasingly precise and individualized. Currently available imaging technologies have the ability to detect and quantify progression in glaucoma, and their measurements may be suitable end points in glaucoma clinical trials.

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“…Numerous studies [17][18][19][20][21][22][23][24] have reported the sensitivity and specificity of different versions of SLP for discriminating between healthy and glaucomatous eyes. Very few studies [25][26][27][28] however have tried to combine SLP variables to obtain an LDF to increase the diagnostic accuracy of isolated GDx-VCC-provided parameters.…”

Section: Discussionmentioning

confidence: 99%

Scanning laser polarimetry: logistic regression analysis for perimetric glaucoma diagnosis

Ferreras

Pablo

Pajarín³

et al. 2008

Eye

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Purpose To calculate and validate a linear discriminant function (LDF) for scanning laser polarimetry (SLP) with variable corneal compensation (GDx-VCC) to increase the diagnostic accuracy when using isolated retinal nerve fibre layer (RNFL) parameters to discriminate between healthy and glaucomatous eyes with visual field loss. Methods We prospectively selected two independent samples (teaching and validating sets). The teaching set, comprising 71 consecutive healthy subjects and 73 patients with open-angle glaucoma, was used to calculate the LDF. The validating set, comprising 72 consecutive normal eyes and 76 glaucoma patients, was used to test the performance of the LDF in an independent population. Receiver operating characteristic (ROC) curves were plotted for the validating set to evaluate the diagnostic accuracy of the LDF and the SLP parameters. Results The obtained function was LDF ¼ À12.20 þ (0.15 Â nasal average)À(23.85 Â normalized inferior area) þ (1.18 Â maximum modulation). The areas under the ROC curve were 0.901 and 0.893 for our LDF and 0.893 and 0.877 for the nerve fibre indicator (NFI) in the teaching and validating populations, respectively. There were no significant differences between these values (P ¼ 0.743 in the teaching set, and P ¼ 0.458 in the validating set). NFI was the SLP-provided parameter with the best sensitivity-specificity balance. Sensitivities were 57.89% for the LDF and 48.68% for NFI at 95% fixed specificity. Conclusions The LDF and NFI were the most accurate SLP parameters for diagnosing glaucoma. The LDF yielded the highest sensitivity at 95% fixed specificity to discriminate between normal and glaucoma subjects.

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Detection of Glaucoma Using Scanning Laser Polarimetry with Enhanced Corneal Compensation

Abstract: GDx ECC performed significantly better than VCC for diagnosing glaucoma in patients with more severe atypical patterns of retardation and at earlier stages of disease.

Cited by 91 publications

References 19 publications

Retinal nerve fiber layer evaluation of spectral domain optical coherence tomograph and scanning laser polarimeter to diagnose glaucoma

Retinal nerve fiber layer evaluation of spectral domain optical coherence tomograph and scanning laser polarimeter to diagnose glaucoma

Assessment of rates of structural change in glaucoma using imaging technologies

Scanning laser polarimetry: logistic regression analysis for perimetric glaucoma diagnosis

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